Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan

<b>Background/Objectives</b>: Although chronic infection by <i>Pseudomonas aeruginosa</i> among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with <i>P. aeruginosa</i> coverage in patients with bronchiectasis who experie...

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Main Authors: Akihiko Hagiwara, Hisayuki Shuto, Ryohei Kudoh, Shota Omori, Kazufumi Hiramatsu, Jun-ichi Kadota, Kiyohide Fushimi, Kosaku Komiya
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/13/12/1182
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author Akihiko Hagiwara
Hisayuki Shuto
Ryohei Kudoh
Shota Omori
Kazufumi Hiramatsu
Jun-ichi Kadota
Kiyohide Fushimi
Kosaku Komiya
author_facet Akihiko Hagiwara
Hisayuki Shuto
Ryohei Kudoh
Shota Omori
Kazufumi Hiramatsu
Jun-ichi Kadota
Kiyohide Fushimi
Kosaku Komiya
author_sort Akihiko Hagiwara
collection DOAJ
description <b>Background/Objectives</b>: Although chronic infection by <i>Pseudomonas aeruginosa</i> among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with <i>P. aeruginosa</i> coverage in patients with bronchiectasis who experienced bacterial pneumonia or exacerbation of bronchiectasis has not been fully investigated. <b>Methods</b>: This study targeted patients with bronchiectasis who were admitted to hospitals because of bacterial pneumonia or exacerbation of bronchiectasis between April 2018 and March 2020 using a national inpatient database in Japan. The association of antipseudomonal antibiotic treatment with in-hospital mortality was assessed after propensity score matching to adjust the patients’ backgrounds. <b>Results</b>: In total, 4943 patients with bacterial pneumonia and 1914 patients with exacerbation of bronchiectasis were included in this study. The in-hospital mortality rate did not differ between patients who did and did not receive antipseudomonal agents among patients with bacterial pneumonia (9.0% [185/2045] vs. 7.4% [151/2045]; <i>p</i> = 0.053) and those with exacerbation of bronchiectasis (5.2% [42/803] vs. 4.1% [33/803] group; <i>p</i> = 0.287). <b>Conclusions</b>: The use of antibiotics covering <i>P. aeruginosa</i> does not apparently improve prognosis in patients with bacterial pneumonia or exacerbation of bronchiectasis. A prospective study focusing on the impact of antibiotics covering <i>P. aeruginosa</i> among patients with bronchiectasis in whom <i>P. aeruginosa</i> is isolated is required.
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spelling doaj-art-78cbf61d929a486a95804e9c8202e3592025-08-20T02:53:41ZengMDPI AGAntibiotics2079-63822024-12-011312118210.3390/antibiotics13121182Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in JapanAkihiko Hagiwara0Hisayuki Shuto1Ryohei Kudoh2Shota Omori3Kazufumi Hiramatsu4Jun-ichi Kadota5Kiyohide Fushimi6Kosaku Komiya7Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, JapanRespiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, JapanRespiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, JapanRespiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, JapanRespiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, JapanRespiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, JapanDepartment of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, JapanRespiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Oita, Japan<b>Background/Objectives</b>: Although chronic infection by <i>Pseudomonas aeruginosa</i> among patients with bronchiectasis is associated with poor prognosis, the impact of antibiotics with <i>P. aeruginosa</i> coverage in patients with bronchiectasis who experienced bacterial pneumonia or exacerbation of bronchiectasis has not been fully investigated. <b>Methods</b>: This study targeted patients with bronchiectasis who were admitted to hospitals because of bacterial pneumonia or exacerbation of bronchiectasis between April 2018 and March 2020 using a national inpatient database in Japan. The association of antipseudomonal antibiotic treatment with in-hospital mortality was assessed after propensity score matching to adjust the patients’ backgrounds. <b>Results</b>: In total, 4943 patients with bacterial pneumonia and 1914 patients with exacerbation of bronchiectasis were included in this study. The in-hospital mortality rate did not differ between patients who did and did not receive antipseudomonal agents among patients with bacterial pneumonia (9.0% [185/2045] vs. 7.4% [151/2045]; <i>p</i> = 0.053) and those with exacerbation of bronchiectasis (5.2% [42/803] vs. 4.1% [33/803] group; <i>p</i> = 0.287). <b>Conclusions</b>: The use of antibiotics covering <i>P. aeruginosa</i> does not apparently improve prognosis in patients with bacterial pneumonia or exacerbation of bronchiectasis. A prospective study focusing on the impact of antibiotics covering <i>P. aeruginosa</i> among patients with bronchiectasis in whom <i>P. aeruginosa</i> is isolated is required.https://www.mdpi.com/2079-6382/13/12/1182bronchiectasis<i>Pseudomonas aeruginosa</i>antibioticpneumoniaexacerbation of bronchiectasis
spellingShingle Akihiko Hagiwara
Hisayuki Shuto
Ryohei Kudoh
Shota Omori
Kazufumi Hiramatsu
Jun-ichi Kadota
Kiyohide Fushimi
Kosaku Komiya
Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan
Antibiotics
bronchiectasis
<i>Pseudomonas aeruginosa</i>
antibiotic
pneumonia
exacerbation of bronchiectasis
title Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan
title_full Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan
title_fullStr Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan
title_full_unstemmed Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan
title_short Impact of Antipseudomonal Antibiotics in Patients with Bronchiectasis Who Experienced Exacerbation or Developed Pneumonia: A Nationwide Study in Japan
title_sort impact of antipseudomonal antibiotics in patients with bronchiectasis who experienced exacerbation or developed pneumonia a nationwide study in japan
topic bronchiectasis
<i>Pseudomonas aeruginosa</i>
antibiotic
pneumonia
exacerbation of bronchiectasis
url https://www.mdpi.com/2079-6382/13/12/1182
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